Title: New Bundled Payment System For Cardiology Will Shift Power From Hospitals To Physicians
1(No Transcript)
2New Bundled Payment System For Cardiology Will
Shift Power From Hospitals To Physicians
Health insurance plans and the new bundled
payment systems for physical treatments including
cardiovascular procedures shift from time to
time. This scenario has presented hospitals and
physicians to rethink their strategy when it
comes to proving services to an individual with
cardiology issues. The medical billers and coders
who work on such claims need to verify it not
once, but two to three times as it needs to be
crystal clear as to where most of the
reimbursement is getting drained or why is there
a delay in payment posting. Encounter-based,
bundled repayments have now appeared at the
forefront of the national discussion on combating
rising health care costs. The most preferred,
fee-for-service model for reimbursement,
hospitals, physicians, and post-acute care
providers file distinct claims and are paid
separately for provided services even when they
are related to a single encounter of care. But,
but, but. Theres a catch to this approach of
payment as it encourages fragmented care, with
little incentive for resource stewardship,
coordination, or communication across multiple
providers. On the contrary, bundled payments seek
to align the interests of providers by as long as
a fixed payment for all services delivered during
a single episode of care this payment is
distributed among all providers in a health care
system involved with that patient, including
hospitals and other facilities.
3New Bundled Payment System For Cardiology Will
Shift Power From Hospitals To Physicians
- The medical billing team should also remember
that although not a new policy initiative,
bundled payments have resurfaced in the current
era of health care reform with its advocates
arguing that it can curtail health care costs
while simultaneously improving quality. -
- Cardiology Payments
- Cardiology procedure and care is the area in
which the implementation of bundled payments is
arguably most visible and maybe most impactful.
Many of the previous demonstrations of bundled
payments have concentrated on and around
cardiovascular conditions, and going forward it
is likely that future efforts will continue to do
so with good reason. - Firstly, cardiology issues are common, costly,
and deadly, and therefore, important to national
discussions for health care reform. - Secondly, care for cardiology procedures involves
multiple provider chains ranging from different
disciplines that include primary care, cardiac
surgery, anesthesiology, and radiology. - Lastly, cardiology patients can receive care in
multiple health care settings such as hospitals,
outpatient and primary care facilities,
subspecialty clinics, skilled nursing facilities,
solo physician facilities, etc.
4New Bundled Payment System For Cardiology Will
Shift Power From Hospitals To Physicians
- Given all reasoning of the above factors, bundled
payments have the potential to substantially
improve care coordination and generate savings
for cardiovascular care, but in the end, it also
gives more payment options to physicians rather
than hospitals. - To Present New Bundle Payment Scheme In Simple
Words - Bundled payments are a middle ground in the
spectrum of health care payment models. On one
side they are considered as a shift from the
traditional fee-for-service model, where
providers are reimbursed separately for each
distinct service provided. However, bundled
payments are not representative of global
payments, or capitation, where a health care
system is paid a lump-sum payment per attributed
patient over a distinct time period, regardless
of the number of distinct episodes of care. - Additionally, payments are intended to encompass
care across multiple cardiology conditions that a
patient may require while each individual
encounter of care is distinct and reimbursed
separately in a bundled payment model.
5New Bundled Payment System For Cardiology Will
Shift Power From Hospitals To Physicians
- In this scenario, there are other alternative
payment and delivery system reforms that fit
between the extremes of fee-for-service and
global payments on the spectrum of health care
payment. These include value-based payments,
where health systems or providers are given
additional payments for high-quality care or
levied financial penalties for poor quality care,
and accountable care organizations where certain
services or conditions may be covered in a
capitated model, but other ancillary services may
still be provided under fee-for-service. -
- Medical Billers and Coders is a
pioneering Cardiology Billing and Coding Company.
We offer complete Cardiology Medical Billing
Services in the United States for Cardiologists.
Our Coders make the Billing Process more
efficient for the practice. -